HomeMy WebLinkAboutHomestead_LeeCLAIM FOR HOMESTEAD PROPERTY TAX V�C TpRM y `YEAR
CREDIT/STANDARD DEDUCTION �I
Stets Form 5173 (RB /1-03)
Presrnbed by the DepaMront of Local Government Finance
INSTRUCnONS: See reara9 o-, . dal br Mhq ku&ucdom SEP 0 1 2006
I (we) certiip ks�8Nt6a7lstld�y oPrMarr3jp20
I e) p as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby daimed:
(We owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
iCONTRACTRECORDEO''`a'"yR:f °fir's= ti.£.��'-
i 4
If buying on cenbad, Fee Simple owner's name
Recordees office where contract is recorded Record number Page
P.ERTX.OWNED� BY CLAIMANT -IWOTHER'COUNTIES."`'_ -;- ut;ayt'`S�`
P.ROP.ERTYsOESCRIP.TION
County
Tomship
Timing
'ty, town, ownsh )��
Parcel number /
I descri io
..3
Is the property i question:
_ (O
� G
Real property ❑ Mobde Homo (W. 6-1.1 -7) .
If any portion of the residential structure or the Ian exceeding one (1) cre at im diate surrounds that s ctum is used to produce income, describe the use and portion
the
of party utilized b produce income.
Z�
°"'!}.�,r,,>VALU�v_>ti�'
-/9- 031 -06)1 ao.169 -099
P.ERTX.OWNED� BY CLAIMANT -IWOTHER'COUNTIES."`'_ -;- ut;ayt'`S�`
County Township
County Tovnship
hereby certify the above statements are true, correct and complete.
ignature aimant
dress (number and stmel, dry, state, ZIP code)
3 (3 rJ Rye S l��.b 24P 3
ASSESSOR USE ONLY
..3
ASSESSED VALUE
1° HOMESTEAD
-r�N - <
'i f ON _RESIDENTIAL
AT 100 °A.OFrTTV
pa•"-, VALUEuys
°"'!}.�,r,,>VALU�v_>ti�'
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other land
(2)
1 f=
DWI
- wT
Tdal land (line 7 plus line 2)
(3)
Dwelling
(4)
. ~u <-�
�r
I`
Residential improvements or Annually
Astlea>red Mobile / Mww%cNred Harm
Garage
(5)
fE'4r + i
Other improvements
(6)
suA "
3 .� Y N
Trial improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20
Lesser of 112 Homestead
valuation or S35.000
SIAIL FORM !MIr/SW1 TREMBLER IOWA'MIA 2MIt PLI11(11.1111:0 BY nil APPIROVED rNOTICETO HOMESTEADrP GOVELNMEN't FINANCE :_a
Gibson County Auditor
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ner for homestead fraud.Ilomestead fraud causes higher tat bills for all:therefore.
• HEA 1341-31109 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government ro better monitor homestead
filings.This information will he Lep confidential and can only be accessed by authorized county officials.The Depanntem of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Lee, Joel E/Debra L
313 N Race
Ilaubstadt IN 47639
3074
• Joel E Lee
313 N Race St State Parcel Number Legal Description
HAUBSTADT IN 47639-8109
26-19-31-301-000.169-009 013-00169-00 ORIGINAL PLAN
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This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Address(number and street.city,state,and ZIP code) N.4me as property address
3l 3 ti 2r.csz S} Po �L,� la S 1-1n3r,S -k L.1 7/43,
Spouse First 1 Middle Last
See\ 2) tee
Mailing Address(Number and street,city,state,and ZIP code) 'Frame as property address
PART 3:CERTIFICATION '
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property.Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signa Date
•